Proper Use

You will need to take a dose of this medicine under your doctor's supervision in a medical facility.

It is very important that you understand the requirements of the Spravato™ REMS program, and become familiar with the Spravato™ medication guide and patient instructions. Read and follow these instructions carefully to avoid misuse and abuse of this medicine. Ask your doctor if you have any questions. Ask your pharmacist for the medication guide and patient instructions f you do not have one.

Each device contains 2 sprays. Your doctor will tell you how many devices to use depending on your dose.

Do not eat for at least 2 hours and do not drink at least 30 minutes before using this medicine.

To use the nasal device:

  • This medicine is for use only inside the nose. Do not get any of it into your eyes or on your skin. If it does get on these areas, rinse it off right away.
  • Gently blow your nose to clear the nostrils before you use the first device only.
  • Hold the device upright between your thumb and first 2 fingers. Do not press the plunger.
  • Tilt your head back slightly.
  • Insert the device tip into the first nostril. The nose rest should touch the skin between the nostrils.
  • Close the other nostril, then firmly press the plunger all the way up as you slowly breathe through your nose. Sniff gently after spraying.
  • Repeat the steps for the other nostril.
  • If you need to use another device, wait 5 minutes after each device to allow the medicine to be absorbed.
  • If liquid drips down from your nose, dab it with a tissue. Do not blow your nose.

Your doctor may also want you to stay in the medical facility for at least 2 hours to check for unwanted effects.

If you need to take a nasal steroid medicine or decongestant, take these at least 1 hour before using this medicine.


The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For nasal dosage form (solution):
    • For depressive symptoms in patients with major depressive disorder (MDD) with suicidal ideation or behavior:
      • Adults—84 milligrams (mg) 2 times per week for 4 weeks. Your doctor may adjust your dose as needed and tolerated.
      • Children—Use and dose must be determined by your doctor.
    • For treatment-resistant depression (TRD):
      • Adults—The starting dose is 56 milligrams (mg) on Day 1, followed by 56 or 84 mg taken 2 times per week on Weeks 1 to 4. Then, 56 or 84 mg taken once a week on Weeks 5 to 8, followed by 56 or 84 mg taken every 2 weeks or once a week on Week 9 and after. Your doctor may adjust your dose as needed and tolerated.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

This medicine needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.